Healthcare Provider Details

I. General information

NPI: 1376811877
Provider Name (Legal Business Name): KRISTIN ANN CALVITTI MS RN ACNS-BC CMSRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2011
Last Update Date: 12/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 W 10TH AVE 968B DOAN HALL
COLUMBUS OH
43210-1240
US

IV. Provider business mailing address

175 HANFORD ST
COLUMBUS OH
43206-3656
US

V. Phone/Fax

Practice location:
  • Phone: 614-366-1530
  • Fax:
Mailing address:
  • Phone: 440-666-9791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.310349
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberCOA.12862-NS
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: